‘Privatising federal health institutions will raise cost of drugs, medical services, deaths’
HEALTH workers under the aegis of the Joint Health Sector Union (JOHESU)/ Assembly of Healthcare Professional Associations (AHPA) have again kicked against the proposed concessioning and privatisation of health facilities in Nigeria by the Federal Government.
The health workers in an open letter to President Muhammadu Buhari said privatisation of health services is a precursor to increased cost of drugs and diagnostic services which will naturally impact on out-of-pocket costs, leading to hardship and more stress junctures in accessing healthcare. They said concessioning/privatisation of health facilities is a hurricane that compounds unproductivity in healthcare and the preponderance of Nigerians who live in poverty and squalor will not be able to access or afford health and its major components, which include use of safe and efficacious drugs in the event of this dreaded reality.
Chairman, JOHESU, Comrade Bio Joy Josiah, and Executive Member, AHPA, and former President, Pharmaceutical Society of Nigeria (PSN), Olumide Akintayo jointly signed the letter.
The JOHESU/AHPA, which accounts for over 95 per cent of the workforce in the health sector of the economy is an amalgamation of five registered trade unions including: Medical and Health Workers Union of Nigeria (MHWUN); National Association of Nigerian Nurses and Midwives (NANNM); Senior Staff Association of Universities’ Teaching Hospitals Research Institutes and Associated Institutions (SSAUTHRIAI); Nigerian Union of Allied Health Professionals (NUAHP) formerly NUPMTPAM; and Non-academic Staff Union of Educational and Associated Institutions (NASU).
The health workers said any attempt to concession facilities in public health institutions compromises the lives of the vast majority of Nigerians and compounds their existing woes. They said, as a matter of fact, concessioning, privatisation or mutilated Public Private Partnership (PPP) agenda at this point in the evolution of health endeavour in Nigeria is a direct invitation to morbidity and mortality. They said the only option that works in the maximum interest of Nigerians at this time is to allow healthcare remain a social welfare service to consumers of health.
The health workers raised alert to the activities of some selfish entrepreneurs in healthcare aided by major players, especially in the old order of the top management committee of the Federal Ministry of Health (FMOH) between 2015 and May, 2019 who are bent on facilitating a concessioning and privatisation of major health facilities at the federal level to themselves and their equally greedy cronies.
The health workers said Infrastructure Concession Regulatory Commission (ICRC) has won the first leg of this unwholesome and cruel agenda with the recent approval for concessioning of 22 Federal Health Institutions (FHIS). They said the propaganda machine was activated even at the highly prestigious National Institute for Policy and Strategic Studies, Kuru, Nigeria (NIPSS) where a recent NIPSS study tour advocated the need to attain Universal Health Coverage (UHC) in Nigeria using the Lagos example.
They said despite widely held beliefs to the contrary, funding universal public healthcare systems through general taxation is more efficient, creates better healthcare outcomes and is more equitable than the private alternatives.
JOHESU/AHPA posited on some of the direct consequences of concessioning, privatisation, and outsourcing in apocalyptic terms. These, they said, include among others:
1. In view of the monopolistic nature of health systems because of the inelastic nature of their demands, there is little or no probability of competitiveness. It follows that a monopoly, which comes with exploitation, becomes the order of the day. High charges generate crazy profits at the detriment of efficiency, which ultimately defeats the goal of accessibility to health facilities in real terms because health cannot be delivered to vulnerable groups.
2. Equity and accessibility rather than efficiency and profitability should be the benchmark to measure performance in healthcare. Patient-care centered services cannot be the hallmark in concessioning and privatisation because profit is the watchword.
3. In the proposed privatisation and concessioning models, government role is largely regulatory which is at the same cost of owning the FHI. As stronger institutions outlive the weaker ones which further limits availability and choices of the citizens, the monopolistic tendencies of formidable profiteers plays out at the detriment of consumers of health.
4. Concessioning and privatisation call to question the integrity of the management of the FHIS dominated by doctors since the advent of the Teaching Hospital Act of 1985. It is the biggest confirmation of the failure of doctors in the running of public hospital system in Nigeria. How come that these same facilities hitherto dubbed Centres of Excellence in some instances have suddenly become failed enterprises? The only explanation remains that Nigerian doctors are not seasoned administrators or managers of cognate experience. Government therefore needs to tinker with the health system by reverting management of FHIS to professionally trained administrators and managers, while health professionals are allowed to embrace their areas of due competence in public good. This is the trend, which is in alignment with global best practices.
The JOHESU/AHPA appealed to the Federal Government (FG) to be decisive in taking a position that the profiteers, concessionaires, greedy entrepreneurs and their collaborators in government jostling to take over the FHIS be responsible enough to build their own world class health facilities like their presumed equivalents do in the global arena.
The health workers said the tragedy of the ICRC approval of the concessioning of 22 FHIS is one of the negative fall-outs of the Economic Team of the FG between 2015 and 2019.